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        <div class="head-title">会员注册</div>
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            <form class="form-horizontal" role="form" action="" method="post">
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                <div class="panel-body">
                    <div class="form-group">
                        <label for="name" class="col-sm-2 control-label">会员编号</label>
                        <div class="col-sm-10">
                            <input type="text" class="form-control" name="name" placeholder="会员编号" value="">
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                        <label for="password" class="col-sm-2 control-label">登录密码</label>
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                            <input type="text" class="form-control" name="password" placeholder="登录密码" value="">
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                        <label for="password_confirmation" class="col-sm-2 control-label">确认登录密码</label>
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                            <input type="text" class="form-control" name="password_confirmation" placeholder="确认登录密码" value="">
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                    <div class="form-group">
                        <label for="secondPassword" class="col-sm-2 control-label">二级密码</label>
                        <div class="col-sm-10">
                            <input type="text" class="form-control" name="secondPassword" placeholder="二级密码" value="">
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                    <div class="form-group">
                        <label for="secondPassword_confirmation" class="col-sm-2 control-label">确认二级密码</label>
                        <div class="col-sm-10">
                            <input type="text" class="form-control" name="secondPassword_confirmation" placeholder="确认二级密码" value="">
                        </div>
                    </div>

                    <div class="form-group">
                        <label for="realName" class="col-sm-2 control-label">真实姓名</label>
                        <div class="col-sm-10">
                            <input type="text" class="form-control" name="realName" placeholder="真实姓名" value="">
                        </div>
                    </div>

                    <div class="form-group">
                        <label class="col-sm-2 control-label">性别</label>
                        <div class="col-md-10">
                            <div class="radio-inline">
                                <label class="cr-styled">
                                    <input type="radio" name="sex" value="1" checked="checked"> 
                                    <i class="fa"></i>
                                    男 
                                </label>
                            </div>
                            <div class="radio-inline">
                                <label class="cr-styled">
                                    <input type="radio" name="sex" value="2"> 
                                    <i class="fa"></i> 
                                    女
                                </label>
                            </div>
                        </div>
                    </div>
                    <div class="form-group">
                        <label for="identityNumber" class="col-sm-2 control-label">身份证</label>
                        <div class="col-sm-10">
                            <input type="text" class="form-control" name="identityNumber" placeholder="身份证" value="">
                        </div>
                    </div>
                    <div class="form-group">
                        <label for="phone" class="col-sm-2 control-label">手机号</label>
                        <div class="col-sm-10">
                            <input type="text" class="form-control" name="phone" placeholder="手机号" value="">
                        </div>
                    </div>
                    <div class="form-group">
                        <label for="email" class="col-sm-2 control-label">邮箱</label>
                        <div class="col-sm-10">
                            <input type="text" class="form-control" name="email" placeholder="邮箱" value="">
                        </div>
                    </div>

                    <div class="form-group">
                        <label for="bankName" class="col-sm-2 control-label">银行名称</label>
                        <div class="col-sm-10">
                            <select name="bankName" class="form-control">
                                                                <option value=""></option>
                                                                <option value="工商银行">工商银行</option>
                                                                <option value="农业银行">农业银行</option>
                                                                <option value="建设银行">建设银行</option>
                                                                <option value="中国银行">中国银行</option>
                                                                <option value="招商银行">招商银行</option>
                                                                <option value="交通银行">交通银行</option>
                                                                <option value="中国民生银行">中国民生银行</option>
                                                                <option value="中信银行">中信银行</option>
                                                                <option value="兴业银行">兴业银行</option>
                                                                <option value="上海浦东发展银行">上海浦东发展银行</option>
                                                            </select>
                        </div>
                    </div>

                    <div class="form-group">
                        <label for="bankAddress" class="col-sm-2 control-label">开户行</label>
                        <div class="col-sm-10">
                            <input type="text" class="form-control" name="bankAddress" placeholder="开户行" value="">
                        </div>
                    </div>

                    <div class="form-group">
                        <label for="bankCardUserName" class="col-sm-2 control-label">银行卡所属人姓名</label>
                        <div class="col-sm-10">
                            <input type="text" class="form-control" name="bankCardUserName" placeholder="银行卡所属人姓名" value="">
                        </div>
                    </div>

                    <div class="form-group">
                        <label for="bankAccount" class="col-sm-2 control-label">银行账号</label>
                        <div class="col-sm-10">
                            <input type="text" class="form-control" name="bankAccount" placeholder="银行账号" value="">
                        </div>
                    </div>

                    <div class="form-group">
                        <div class="col-sm-2 col-md-offset-6">
                            <button type="button" class="btn btn-primary submit">提交</button>
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